Chronic Pain and Prescription Drug Addiction

Prescription drug misuse can lead to addiction—this is something we’ve all heard about but probably thought, “That could never happen to me. I’d be too careful to let that happen.” But for some people who have become addicted to prescription painkillers such as Lortab, Vicodin, etc., the beginning of the addiction was an innocent, well-meaning and careful effort to manage pain.

As a therapist I can tell you that for every person I treated in my clinic who became addicted to opiates via buying them on the street or escalating from a different illicit drug in search of a more intense high, there was another person who had become addicted after being prescribed the substances legally and legitimately for pain. Add in the people who used a friend or family member’s leftover medications to manage pain and the people seeking to self medicate physical conditions definitely outnumbered the people seeking a recreational high.

Imagine having a chronic condition that causes pain—anything from tendonitis to migraines. Imagine that you have gone to the doctor and perhaps even a specialist or two, and followed all the advice you’ve been given. You do your stretches regularly or take all the medications prescribed. But you still experience severe pain, at least some of the time. What would you do? Likely go back to the doctor, at least once more, to provide the feedback that despite doing all you’ve been told, you’re still quite uncomfortable. For this example, let’s imagine that your doctor decides that the only recourse is to prescribe painkillers.

In a different scenario, we can imagine that after trotting off to the specialist and following all recommendations—and not getting better—you might not return to the doctor. Discouraged and in pain, unable to sleep on a particularly bad night, you might ransack the medicine cabinet to see if you have anything lying around that might help. Your partner had dental work or back surgery a few months ago and didn’t use all their pain medication. You find the bottle and take just one, just this once.

What happens next is hard to understand if you’ve never experienced it. The relief, assuming the pill you took worked, is so intense, so wonderful and overwhelming, it can be almost like a “high” in itself. Now you have the triple play: a physiological potential for addiction because the substance itself is physically addictive, the learned behavior cemented in your brain that taking this substance eases your pain, and the psychologically addictive high you experienced when the pain finally faded.

What Can You Do to Prevent Prescription Drug Addiction?

Living in pain is a risk factor for addiction and a risk factor for relapse if you are in recovery. Chronic pain is a dangerous physical and mental health issue that you need to take seriously in order to protect yourself and your family.

Don’t keep old medications around. Properly dispose of all leftover medications, as soon as you can.

If you have used someone else’s medications, tell your doctor immediately. If you have your own prescription and the dosages are not providing relief, tell your doctor immediately. Advocate for yourself, and be clear and honest about what you’re experiencing, both physically in terms of your pain level, and emotionally in terms of experiencing any cravings for more medication.

Cravings and feelings of near panic about needing relief are normal for people who are struggling with pain and opiate use. Try not to feel ashamed or get angry or upset about what’s happening. Stay focused on solving the problem, not beating yourself up.

Seek help, and help yourself by being honest. Denial, lying and deceiving others are key components of addiction. Honesty is like sunshine, killing the mildew of addiction.

Be honest and open with your doctor about any other current substance use (for example, if you drink alcohol, tell your doctor about that). Certain combinations can be deadly.

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